Mycoplasma e Ureaplasma em gestantes HIV- positivas
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Dec 29, 2024
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Resumo
Objetivo: Comparar a prevalência cérvico-vaginal das espécies de Mollicutes: Mycoplasma genitalium, M. hominis, Ureaplasma parvum e U. urealyticum entre gestantes de acordo com o status de infecção pelo HIV. Métodos: Trata-se de um estudo longitudinal prospectivo que incluiu 29 gestantes HIV-positivas e 34 HIV-negativas. Todas as participantes responderam um questionário para obtenção de dados sociodemográficos e comportamentais. Amostras cérvico-vaginais foram coletadas e testadas molecularmente para as quatro espécies de Mollicutes. As taxas de prevalência foram comparadas entre os grupos de estudo utilizando o teste exato de Fisher ou qui-quadrado. Resultados: A prevalência de Mollicutes foi superior em mulheres HIV-positivas (51,7%; n=15) quando comparada com o grupo de gestantes HIV-negativas (12,0%; n=4), (p<0,001). A espécie mais frequentemente detectada foi U. parvum, presente em 12 (41,4%) amostras de gestantes HIV-positivas e 2 (6,0%) amostras de gestantes HIV-negativas (p<0,01). A análise longitudinal mostrou que gestantes com HIV tiveram um número maior de momentos positivos para Mollicutes quando comparadas às mulheres HIV-negativas (p = 0,01). Conclusão: Os dados de prevalência de Mollicutes aqui apresentados pode nortear estratégias diagnósticas para tais microrganismos, se clinicamente indicado.
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Como Citar
SidrinsN. S., AndradeC. P. de, NogueiraK. da S., SilvaM. G. da, TristãoE. G., CarvalhoN. S. de, & MarconiC. (2024). Mycoplasma e Ureaplasma em gestantes HIV- positivas. Revista Eletrônica Acervo Saúde, 24(12), e18230. https://doi.org/10.25248/reas.e18230.2024
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Referências
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9. DURSKI M, et al. Comparison of two microscopic interpretations of vaginal microbiota with molecular profiling. Diagn Microbiol Infect Dis. 2022; 104: 115728.
10. EROGLU S e ASGIN N. Bacterial vaginosis and Mycoplasma infections in reproductive-age women: Clarifying the association with risk factors, Clínica e Investigación en Ginecología y Obstetricia. 2022; 49(4).
11. FOESSLEITNER P, et al. HIV infection as a risk factor for vaginal dysbiosis, bacterial vaginosis, and candidosis in pregnancy: A matched case-control study. Birth. 2021; 48(1): 139-146.
12. GALLO MF, et al. Bacterial vaginosis, gonorrhea, and chlamydial infection among women attending a sexually transmitted disease clinic: a longitudinal analysis of possible causal links. Ann Epidemiol. 2012; 22: 213-20.
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15. GOVENDER L, et al. Bacterial vaginosis and associated infections in pregnancy. Int J Gynaecol Obstet. 1996; 55: 23-28.
16. HORNER P, et al. Should we be testing for urogenital Mycoplasma hominis, Ureaplasma parvum and Ureaplasma urealyticum in men and women? - a position statement from the European STI Guidelines Editorial Board. J Eur Acad Dermatol Venereol. 2018; 32(11): 1845-1851.
17. LARSEN B e HWANG J. Mycoplasma, Ureaplasma and Adverse PregnancyOutcomes: A fresh Look. Infectious Diseases in Obstetrics and Gynecology, 2010; 52: 521921.
18. LIMA LM, et al. Sexually Transmitted Infections Detected by Multiplex Real Time PCR in Asymptomatic Women and Association with Cervical Intraepithelial Neoplasia. Rev Bras Ginecol Obstet. 2018; 40(9): 540-546.
19. LINHARES IM, et al. Ureaplasma urealyticum colonization in the vaginal introitus and cervix of human immunodeficiency virus-infected women. Int J STD AIDS. 2000; 11(3): 176-9.
20. LIS R, et al. Mycoplasma genitalium Infection and Female Reproductive Tract Disease: A Meta-Analysis. Clinical Infectious Diseases Advance. 2015; 61: 418-26.
21. LOBÃO TN, et al. Ureaplasma urealyticum e U. parvum em mulheres sexualmente ativas atendidas em postos de saúde públicos no Brasil. Epidemiol Infect. 2017; 145: 2341-235.
22. MARCONI C, et al. Líquido amniótico Interleucina-1 beta e interleucina-6, mas não interleucina-8, correlacionam-se com a invasão microbiana da cavidade amniótica no trabalho de parto prematuro. Jornal Americano de Imunologia Reprodutiva. 2011; 65: 549-556.
23. MARSCHALKÓ M e AMBRUS L. A női alsó genitalis traktus mikrobiom tulajdonságai és szerepe [Characteristics and physiologic role of female lower genital microbiome]. Orv Hetil. 2023; 164(24): 923-930.
24. MATOS MS, et al. Clinical and uterine cervix characteristics of women with Mycoplasma and Ureaplasma in genital discharge. Rev Assoc Med Bras (1992). 2024; 70(6): 20240045.
25. MBU ER, et al. “Gynecological morbidity between HIV Positive Pregnant Women in Cameroon,” Reproductive Health. 2008; 5: 1-5.
26. MOHANTY T, et al. Effect of bacterial vaginosis on preterm birth: a meta-analysis. Arch Gynecol Obstet. 2023 Oct;308(4):1247-1255. doi: 10.1007/s00404-022-06817-5. Epub 2022; 36251068.
27. MUZNY CA, et al. State of the Art for Diagnosis of Bacterial Vaginosis. J Clin Microbiol. 2023; 61(8): 0083722.
28. NUGENT RP, et al. Reliability of diagnosing bacterial vaginosis is improved by a standardized method of gram stain interpretation. J Clin Microbiol. 1991; 29(2): 297-301.
29. NYEMBA DC, et al. Prevalence of curable STIs and bacterial vaginosis during pregnancy in sub-Saharan Africa: a systematic review and meta-analysis. Sex Transm Infect. 2022; 98(7): 484-491.
30. OLIVEIRA CNT, et al. Associação de aborto espontâneo e Ureaplasma parvum detectado no tecido placentário. Epidemiologia e Infecção. 2020; 148: 126.
31. PENNA IA, et al. Freqüência de infecção pelo Mycoplasma hominis e Ureaplasma urealyticum em mulheres inférteis e relação com repercussões clínicas. Rev. Bras. Ginecol. Obstet. 2005; 27(2): 64-8.
32. RUZMAN N, et al. The prevalence and the risk factors of the cervical colonization by the genital mycoplasmas among pregnant women from Eastern Croatia. Coll Antropol. 2013; 37(1): 135-40.
33. SARAF VS, et al. Microbioma vaginal: normalidade vs disbiose. Arco Microbiol. setembro de 2021; 203(7): 3793-3802.
34. SILVA J, et al. Genital mycoplasmas and ureaplasmas in cervicovaginal self-collected samples of reproductive-age women: prevalence and risk factors. International Journal of STD & AIDS. 2018; 29(10): 999-1006.
35. SMULLIN CP, et al. Prevalence and incidence of Mycoplasma genitalium in a cohort of HIV-infected and HIV-uninfected pregnant women in Cape Town, South Africa. Sex Transm Infect. 2020 ; 96(7): 501-508.
36. TIBALDI C, et al. Maternal risk factors for abnormal vaginal flora during pregnancy. Int J Gynaecol Obstet. 2016; 133(1): 89-93.
37. TRAVASSOS AGA et al. Prevalence of sexually transmitted infections among HIV-infected women in Brazil, The Brazilian Journal of Infectious Diseases. 2012; 16(6): 581-585.
38. TUDDENHAM S, et al. Association of Pregnancy and HIV Status With Molecular-Bacterial Vaginosis in Indian Women. J Acquir Immune Defic Syndr. 2023; 93(5): 422-430.
39. WORKOWSKI KA, et al. Sexually Transmitted Infections Treatment Guidelines, 2021. MMWR Recomm Rep. 2021; 70(4): 1-192.
40. YALEW GT, et al. Prevalence of bacterial vaginosis and aerobic vaginitis and their associated risk factors among pregnant women from northern Ethiopia: A cross-sectional study. PLoS One. 2022; 17(2): 0262692.
2. BOUJEMAA S, et al. Association between genital mycoplasmas (Ureaplasma urealyticum and Mycoplasma hominis) and HIV infection: a systematic review and meta-analysis. Aids reviwes. 2023; 25: 1-10.
3. BRAZIL. Ministry of Health. Department of Health Surveillance. Department of STDs, AIDS, and Viral Hepatitis. Clinical Protocol and Therapeutic Guidelines for Comprehensive Care for People with Sexually Transmitted Infections / Ministry of Health, Department of Health Surveillance, Department of STDs, AIDS, and Viral Hepatitis. – Brasília: Ministry of Health, 2015; 120: 55-61.
4. CARNEIRO FP, et al. Cervical Cytology of Samples with Ureaplasma urealyticum, Ureaplasma parvum, Chlamydia trachomatis, Trichomonas vaginalis, Mycoplasma hominis, and Neisseria gonorrhoeae Detected by Multiplex PCR. Biomed Res Int. 2020; 7045217.
5. CHANG-HUI S. Chapter 10 - Amplification of nucleic acids, Editor(s): Chang-Hui Shen, Diagnostic Molecular Biology (Second Edition), Academic Press, 2023; 259-293.
6. CHRISTOFOLINI DM, et al. Prevalence of cases of Mycoplasma hominis, Mycoplasma genitalium, Ureaplasma urealyticum and Chlamydia trachomatis in women with no gynecologic complaints. Reprod Med Biol. 2012; 11(4): 201-205.
7. DJIGMA F, et al. HIV-infected women of Burkina Faso: a “reservoir” of mycoplasma infection. J Infect Dev Ctries. 2011; 5: 176-8.
8. DONDERS GG, et al. Relationship of bacterial vaginosis and mycoplasmas to the risk of spontaneous abortion. Am J Obstet Gynaecol. 2000; 183: 431-7.
9. DURSKI M, et al. Comparison of two microscopic interpretations of vaginal microbiota with molecular profiling. Diagn Microbiol Infect Dis. 2022; 104: 115728.
10. EROGLU S e ASGIN N. Bacterial vaginosis and Mycoplasma infections in reproductive-age women: Clarifying the association with risk factors, Clínica e Investigación en Ginecología y Obstetricia. 2022; 49(4).
11. FOESSLEITNER P, et al. HIV infection as a risk factor for vaginal dysbiosis, bacterial vaginosis, and candidosis in pregnancy: A matched case-control study. Birth. 2021; 48(1): 139-146.
12. GALLO MF, et al. Bacterial vaginosis, gonorrhea, and chlamydial infection among women attending a sexually transmitted disease clinic: a longitudinal analysis of possible causal links. Ann Epidemiol. 2012; 22: 213-20.
13. GOLDENBERG RL, et al. Epidemiologia e causas de nascimento prematuro. Lancet. 2008; 371: 75 -84.
14. GÓMEZ-LOPEZ N, et al. A imunobiologia do trabalho de parto e nascimento pré-termo: inflamação intra-amniótica ou quebra da homeostase materno-fetal. Reprodução. 2022; 164(2): R11-R45.
15. GOVENDER L, et al. Bacterial vaginosis and associated infections in pregnancy. Int J Gynaecol Obstet. 1996; 55: 23-28.
16. HORNER P, et al. Should we be testing for urogenital Mycoplasma hominis, Ureaplasma parvum and Ureaplasma urealyticum in men and women? - a position statement from the European STI Guidelines Editorial Board. J Eur Acad Dermatol Venereol. 2018; 32(11): 1845-1851.
17. LARSEN B e HWANG J. Mycoplasma, Ureaplasma and Adverse PregnancyOutcomes: A fresh Look. Infectious Diseases in Obstetrics and Gynecology, 2010; 52: 521921.
18. LIMA LM, et al. Sexually Transmitted Infections Detected by Multiplex Real Time PCR in Asymptomatic Women and Association with Cervical Intraepithelial Neoplasia. Rev Bras Ginecol Obstet. 2018; 40(9): 540-546.
19. LINHARES IM, et al. Ureaplasma urealyticum colonization in the vaginal introitus and cervix of human immunodeficiency virus-infected women. Int J STD AIDS. 2000; 11(3): 176-9.
20. LIS R, et al. Mycoplasma genitalium Infection and Female Reproductive Tract Disease: A Meta-Analysis. Clinical Infectious Diseases Advance. 2015; 61: 418-26.
21. LOBÃO TN, et al. Ureaplasma urealyticum e U. parvum em mulheres sexualmente ativas atendidas em postos de saúde públicos no Brasil. Epidemiol Infect. 2017; 145: 2341-235.
22. MARCONI C, et al. Líquido amniótico Interleucina-1 beta e interleucina-6, mas não interleucina-8, correlacionam-se com a invasão microbiana da cavidade amniótica no trabalho de parto prematuro. Jornal Americano de Imunologia Reprodutiva. 2011; 65: 549-556.
23. MARSCHALKÓ M e AMBRUS L. A női alsó genitalis traktus mikrobiom tulajdonságai és szerepe [Characteristics and physiologic role of female lower genital microbiome]. Orv Hetil. 2023; 164(24): 923-930.
24. MATOS MS, et al. Clinical and uterine cervix characteristics of women with Mycoplasma and Ureaplasma in genital discharge. Rev Assoc Med Bras (1992). 2024; 70(6): 20240045.
25. MBU ER, et al. “Gynecological morbidity between HIV Positive Pregnant Women in Cameroon,” Reproductive Health. 2008; 5: 1-5.
26. MOHANTY T, et al. Effect of bacterial vaginosis on preterm birth: a meta-analysis. Arch Gynecol Obstet. 2023 Oct;308(4):1247-1255. doi: 10.1007/s00404-022-06817-5. Epub 2022; 36251068.
27. MUZNY CA, et al. State of the Art for Diagnosis of Bacterial Vaginosis. J Clin Microbiol. 2023; 61(8): 0083722.
28. NUGENT RP, et al. Reliability of diagnosing bacterial vaginosis is improved by a standardized method of gram stain interpretation. J Clin Microbiol. 1991; 29(2): 297-301.
29. NYEMBA DC, et al. Prevalence of curable STIs and bacterial vaginosis during pregnancy in sub-Saharan Africa: a systematic review and meta-analysis. Sex Transm Infect. 2022; 98(7): 484-491.
30. OLIVEIRA CNT, et al. Associação de aborto espontâneo e Ureaplasma parvum detectado no tecido placentário. Epidemiologia e Infecção. 2020; 148: 126.
31. PENNA IA, et al. Freqüência de infecção pelo Mycoplasma hominis e Ureaplasma urealyticum em mulheres inférteis e relação com repercussões clínicas. Rev. Bras. Ginecol. Obstet. 2005; 27(2): 64-8.
32. RUZMAN N, et al. The prevalence and the risk factors of the cervical colonization by the genital mycoplasmas among pregnant women from Eastern Croatia. Coll Antropol. 2013; 37(1): 135-40.
33. SARAF VS, et al. Microbioma vaginal: normalidade vs disbiose. Arco Microbiol. setembro de 2021; 203(7): 3793-3802.
34. SILVA J, et al. Genital mycoplasmas and ureaplasmas in cervicovaginal self-collected samples of reproductive-age women: prevalence and risk factors. International Journal of STD & AIDS. 2018; 29(10): 999-1006.
35. SMULLIN CP, et al. Prevalence and incidence of Mycoplasma genitalium in a cohort of HIV-infected and HIV-uninfected pregnant women in Cape Town, South Africa. Sex Transm Infect. 2020 ; 96(7): 501-508.
36. TIBALDI C, et al. Maternal risk factors for abnormal vaginal flora during pregnancy. Int J Gynaecol Obstet. 2016; 133(1): 89-93.
37. TRAVASSOS AGA et al. Prevalence of sexually transmitted infections among HIV-infected women in Brazil, The Brazilian Journal of Infectious Diseases. 2012; 16(6): 581-585.
38. TUDDENHAM S, et al. Association of Pregnancy and HIV Status With Molecular-Bacterial Vaginosis in Indian Women. J Acquir Immune Defic Syndr. 2023; 93(5): 422-430.
39. WORKOWSKI KA, et al. Sexually Transmitted Infections Treatment Guidelines, 2021. MMWR Recomm Rep. 2021; 70(4): 1-192.
40. YALEW GT, et al. Prevalence of bacterial vaginosis and aerobic vaginitis and their associated risk factors among pregnant women from northern Ethiopia: A cross-sectional study. PLoS One. 2022; 17(2): 0262692.